Outpatient laparoscopic cholecystectomy in Hong Kong - Patient acceptance

The authors performed a prospective evaluation of 60 Hong Kong Chinese pati ents with symptomatic gallstones and gallbladder polyps undergoing outpatie nt laparoscopic chalecystectomy in a regional hospital in Hong Kong from Ma rch 1996 to May 1998 to determine the feasibility, satisfaction, and accept ance of this procedure among Chinese patients. Patients with American Socie ty oi Anesthesiologists grade I and IT gallstones ol polyps were selected. Exclusion criteria included 1) history of upper abdominal operations, attac ks of acute cholecystitis, cholangitis, or pancreatitis; 2) abnormal liver function; and 3) ultrasonographic evidence of contracted gallbladder. thick ened gallbladder H:all, dilated common bile duct, or common bile duct stone s. Patients discharged at 5:00 PM OD the day of cholecystectomy were define d as having undergone outpatient procedure. Patients were asked about proce dure acceptance, rated on a scale of 1 to 10 (best), using a standardized q uestionnaire 4 weeks after operation. The study included 21 men and 39 wome n with mean age of 40.5 years (range. 27-59). There were no conversions to open procedures in the series. There were 6 (10%) unanticipated postoperati ve hospital admissions; all patients were discharged on the first postopera tive day. Another patient was readmitted 3 days after operation because of a common bile duct stone, Overall patient acceptance of outpatient laparosc opic cholecystectomy was good, with a mean score of 8.6 of 10. Thirteen pat ients (22%) expressed dissatisfaction with being discharged earlier than th ey had expected. and 9 (15%) would have preferred inpatient cart, Forty-eig ht patients (80%) resumed Iii daily activities by the first postoperative c lay; the remaining 12 did so by the and of the first week. Among the 44 wor king patients, only 4 (9%) resumed full duty within the first postoperative week; 29 (66%) did po by the second week and the remaining 11 (25%) return ed to work after the third week. By selecting appropriate subjects, outpati ent laparoscopic cholecystectomy is feasible and highly accepted among Hong Kong Chinese patients. Approximately one quarter of the patients preferred a longer postoperative stay or inpatient care.